Corrective Jaw Surgery (Orthognathic Surgery)

Orthognathic surgery refers to the surgical correction needed to fix substantial abnormalities of the maxilla (upper jaw), the mandible (lower jaw), or both. The abnormality may be a birth defect, a growth defect, or the result of traumatic injuries to the jaw area.

Orthognathic surgery is generally performed by an Oral and Maxillofacial Surgeon to correct malocclusion (bad bite) in cases where routine orthodontic treatment has not or will not be effective. Orthognathic surgeries include the reconstruction of the mandible or maxilla, mandibular ramus, maxilla osteotomy, and mandibular osteotomy.

There are several classifications of malocclusion (the improper coming together of teeth) which may require orthognathic surgery:

Class I Occlusion –This malocclusion means that the lower anterior incisors sit directly behind the upper anterior incisors when the patient bites down. This is considered less destructive than Class II and Class III malocclusions.

Class II Malocclusion – This is identified when the lower anterior incisors lie significantly behind the upper anterior incisors during the biting process; in some cases hitting the soft tissue behind the upper incisors. This is commonly referred to as an overbite and can cause discomfort, bone damage, excessive wear of the front teeth, and tooth loss.

Class III Malocclusion – This is commonly known as an underbite and occurs when the lower anterior incisors and lower jaw are positioned beyond the upper teeth, making the lower jaw much more prominent than the upper jaw.

Reasons for orthognathic surgery

The malocclusion of the teeth can create greatly destructive forces among the five powerful muscles that control the closing and opening of the jaw. These muscles generate a tremendous force when clenching, grinding or chewing. Misalignment can seriously damage the function and aesthetic appearance of the teeth in many ways if left untreated, such as:

Tooth Wear – In the case of an overbite, the pressure and wear on the teeth is not spread evenly. This can also lead to TMJ, migraine headaches, and tooth loss.

Chronic Jaw, Muscle Pain & Headache – The misalignment of the teeth alters the way the facial muscles interact. In some cases, the meniscus cartilage which acts as a buffer between the jawbones can be painfully damaged.

Loose Teeth – When uneven pressure is continually exerted in unintended places or soft tissue is damaged by an overbite, adjacent teeth may become loose in their sockets which causes pain and reduces proper function.

Tooth Sensitivity – As teeth become damaged by constant use, the enamel becomes thinner and the nerves are less protected. This lack of protection can lead to sharp pains when hot or cold foods are eaten.

Difficulty Swallowing, Chewing, or Biting Food – Each can be associated with muscle pain and/or poor alignment of the upper and lower jaws.

What does orthognathic surgery involve?

When the dentist identifies a patient as a candidate for orthognathic surgery, a complete photographic analysis is initially undertaken. This includes panorex x-rays, cephalometric x-rays, models, impressions, and radiographs. Your oral & maxillofacial surgeon, your orthodontist and Dr. Neal will work together and consider how the corrective surgery will impact both proper jaw function and the aesthetic appearance of the entire face.

Generally, orthodontic braces are necessary to align the arches and straighten the teeth prior to the surgery, and additionally, retainers may be used after the surgery. During maxillary surgery, the upper jaw is moved and may be secured in position using tiny plates, wires, rubber bands and screws. Surgery on the mandible is performed using bone grafts to align the lower jaw into the correct position. Orthognathic surgery generally requires a general anesthesia and a good deal of aftercare. Pain medication will be prescribed as necessary, and you’ll be given post treatment advice for your recovery. You may also be provided with a modified diet (if required).

Testimonials

Email from patient to Dr. Neal titled: It was a dark and rainy night - How a Landmark Dental employee saved a Neal patient

"In mounting pain for over a month, Nicole managed to surreptitiously remove a piece of something trapped between my gum and #14 tooth......I was (gratefully) popped in on an emergency appointment (thank you Sarah). I would love to know how Nicole was able to locate and remove the morsel, which must have been causing the continued pain, because when I drove home I noticed for the first time in weeks the pain was abating.

The circumstances for the recommendation of my using the Perio Plus are now vague in my mind, but when Sarah found out I lived in Victoria, she offered to drop off a bottle to me on her way home. Sarah doesn't live next door to me, you understand, but in her mind, it was close enough to warrant her going out of her way to make sure I was able to start using the Perio Plus quickly.

She did indeed drive all the way to our home, in the dark, pretty late at night, pulling in to the wrong, but close, driveway down the street, and calling me on her cell. I flew out of the house, phone in my hand, dressing gowned and slippered, in the dark and rainy night, running down the street to grab the bottle and give her a kiss for her trouble.

What a terrific staff! Going way beyond the call of duty, demonstrating true caring and support. One could never imagine any employee stretching themselves for a patient that way. I am impressed and grateful. Imagine the loyalty such an action motivates. Who hired this woman? Kudos!

Thank you from the heart.
Shelly S

Patient: Shelley S.

Quality work, done very efficiently, with no pain, and friendly service! What more can you ask for from a dental office! This father and son dental team are clearly very knowledgeable and definitely some of the best on the island. Their staff are fun to be around, very courteous, and helpful. The office is very cozy, neat, and ocean views to boot!! Highly recommended!!!

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below. E-mails are checked once per day Monday through Friday. If a reply or appointment booking is needed immediately, or to change a previously reserved appointment time, please phone us directly at 250-656-4848.